NPR tried to put a predictable pro-Obama/Hillary spin on the study, with the lede on one story reading:

A series of polls in key states by NPR and its partners finds that more than half of adults in the U.S. believe the Affordable Care Act has either helped the people of their state or has had no effect. Those sentiments are common despite all the political wrangling that continues over the law.

That is certifiably pathetic. The poll is strongly negative. To tout "no effect" as some kind of achievement is not journalism.

The only reason 45% of the respondents did not see premium rises is their employer has shielded them from the increases (so far).

Yup, I don't remember Obama, Pelosi and Reid campaigning to pass an ObamaCare that 'would have no effect' on their health care.

Wait, I will concede this part: Obama did say "If you like your doctor, you can keep your doctor. If you like your plan, you can keep your plan".Yeah, that didn't quite work out as promised, did it?

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

And when they do, so will many consumers. The trade journal Inside Health Policy warns that insurers might drop plans that qualify for the lowest cost tier in the ObamaCare exchanges and instead focus on the silver level, thanks to an effort by CMS to shore up the financial models of larger insurers. When that happens, Leslie Small writes at Fierce Health Payer, expect an exodus of low-risk consumers who may be unmotivated to pay for an expensive plan they neither need nor will use:

One problem, according to the article, is risk adjustment–as CMS data indicate bronze is the only metal level for which insurers of all sizes in the individual and group markets had to pay into the program. Federal officials are considering some changes to the risk adjustment program, which some say unfairly penalizes smaller insurers.

Already, filings show a CareFirst BlueCross BlueShield subsidiary in Virginia will transform its bronze plans into silver-level plans for 2017, according to Inside Health Policy, and experts tell the publication this could set a troubling precedent for the industry.

If insurers do drop their bronze plans, it would have the effect of further destabilizing the marketplace, according to Sean Mullin, a senior director at Leavitt Partners. That’s because such enrollees, which tend to be lower-risk and want the cheapest plans, will likely leave the marketplace altogether, further depleting the exchanges’ share of healthier enrollees.

The model already has fallen far short of sustainability, notes Stephen Green at PJ Media. Bailing out of the bronze plans will make that situation worse:

In order to achieve solvency, the ObamaCare exchanges require 40% of their customers to be young and healthy enough to pay large sums over time into the markets without taking out much in benefits. That way there’s enough money in the coverage pool to pay for older and sicker customers. However, currently only about 28% of ObamaCare customers are young and healthy enough to keep the system afloat. …

Comparatively inexpensive Bronze plans are one way to get younger and healthier people paying into the system — but for the Young & Healthy, those plans are too expensive to buy (even with subsidies) and too expensive to use (due to sky-high copays and deductibles). For many, already it’s cheaper just to pay the penalty-tax-thing for non-coverage and take their chances — which for the Y&H is usually a safe bet.

As noted before, the proper insurance model for the Y&H would be a low-cost hospitalization/catastrophic-level insurance plan with HSAs for any out-of-pocket costs. Thanks to the combination of high deductibles and the mandate to pay for comprehensive coverage, the Y&H end up stuck with a plan that is, in practical use, high-cost catastrophic coverage with thousands more due in deductibles before the benefits pay out at all. If insurers bail out of the bronze level, then these Y&H will have to pay even higher premiums. It’s smarter for them to pay the penalty and then work the system to get coverage if they become seriously ill or injured.

Even if they don’t bail out of the bronze level, the premiums will skyrocket … again. Insurers in Oregon and Virginia are warning of double-digit premium increases, and the low-cost alternative in New Hampshire wants in on that action too:

Oregon’s largest individual market insurer has filed for an average 29.6% rate hike for 2017 policies sold on and off the ObamaCare exchange.

Providence Health, which saw enrollment nearly quadruple in 2016 to 100,900, grabbing 40% of the market, blamed the increase partly on next year’s phase-out of ObamaCare’s temporary reinsurance program, which covers some of the bills of the costliest patients. …

Overall, Oregon insurers are seeking an average 27% premium hike, as calculated by ObamaCare enrollment tracker ACASignups.net, weighted based on 2016 enrollment.

Oregon is just the second state to make public initial rate requests filed by all insurers for 2017. Participants in Virginia’s market are seeking an average 17.9% hike, including a 15.8% increase requested by Anthem (ANTM) for its 180,000 members in ObamaCare-compliant plans.

In New Hampshire, Minuteman Health, the lowest-cost and second-largest exchange participant, has requested a 45.2% premium hike.

So much for bending cost curves downward, eh? With the third-place tier going away, I’m tempted to use a Glengarry Glen Ross reference here, except that “always be closing” has such a different meaning here. And the steak knives are basically already in the backs of consumers in the ObamaCare exchanges anyway. Downward cost curves are for closers (NSFW):

The irrational funding structure of ObamaCare has long been demonstrated. According to a federal judge, at least part of it is also unconstitutional. The Obama administration lost in court this afternoon when the judge ruled in favor of the House of Representatives in a lawsuit challenging the funding of subsidies for insurers in the exchanges — potentially stopping $175 billion in subsidies:

The Obama administration unlawfully paid billions of dollars to insurance providers under the Affordable Care Act without a funding appropriation from Congress, a federal district judge in Washington ruled on Thursday.

The insurance subsidies were designed to offset discounts that insurers were required to give eligible lower-income Americans under the health care reform law. U.S. District Judge Rosemary Collyer said federal agencies could not fund the subsidies through another section of the health care law that allocated money for tax credits.

“Paying out Section 1402 reimbursements without an appropriation thus violates the Constitution,” Collyer wrote. “Congress authorized reduced cost sharing but did not appropriate monies for it, in the FY 2014 budget or since. Congress is the only source for such an appropriation, and no public money can be spent without one.”

That could mean an even faster destabilization of the irrational model at the heart of ObamaCare, of which more in a moment. The preliminary ruling on standing distinguished between subsidies paid to consumers in the exchanges (section 1401), which are statutory obligations through federal tax law, and those paid to insurers (section 1402), which are not part of tax law at all:

Properly understood, however, the Non-Appropriation Theory is not about the implementation, interpretation, or execution of any federal statute. It is a complaint that the Executive has drawn funds from the Treasury without a congressional appropriation—not in violation of any statute, but in violation of Article I, § 9, cl. 7 of the Constitution.17 The NonAppropriation Theory, in other words, is not about how Section 1402 is being applied, but rather how it is funded.

The issue, in other words, was that the executive branch had usurped the power of the purse. HHS argued that the House could have simply cut off funding for 1402 in explicit language, leading the judge to quote the House response that HHS was “apparently oblivious to the irony.” In order for the power of the purse to be a practical check, it has to be effective — and that’s exactly what HHS’ actions undermined:

The Secretaries further argue that the House is not injured by the lack of an appropriation because it can remedy or prevent that injury through means outside this lawsuit. Id. at 19-20. Chief among those means, they contend, is “the elimination of funding.” Id. As the House points out, the Secretaries are “apparently oblivious to the irony” of their argument. Opp’n at 35. Eliminating funding for Section 1402 is exactly what the House tried to do. But as the House argues, Congress cannot fulfill its constitutional role if it specifically denies funding and the Executive simply finds money elsewhere without consequence. Indeed, the harm alleged in this case is particularly insidious because, if proved, it would eliminate Congress’s role via-a-vis the Executive.The political tug of war anticipated by the Constitution depends upon Article I, § 9, cl. 7 having some force; otherwise the purse strings would be cut.

The Court finds equally unpersuasive the argument that Congress “could repeal or amend the terms of the regulatory or appropriations authority that it has vested in the Executive Branch.” Mem. at 19.23 But the authority trespassed upon under the Non-Appropriation Theory is not statutory; it is constitutional. It was not vested in the Executive by Congress; it was vested in Congress by sovereign people through constitutional ratification. Neither Congress nor the Executive has the authority to repeal or amend the terms of Article I, § 9, cl. 7.

Today, Rosemary Collyer rejected the argument that the statutory obligations to fund 1401 meant that HHS could commingle monies to fund 1402:

“If the statutory language is plain, we must enforce it according to its terms.” King v. Burwell, 135 S. Ct. 2480, 2489 (2015). Although the “meaning—or ambiguity—of certain words or phrases may only become evident when placed in context,” id., the statutory 2 provisions in this case are clear in isolation and in context. The Affordable Care Act unambiguously appropriates money for Section 1401 premium tax credits but not for Section 1402 reimbursements to insurers. Such an appropriation cannot be inferred. None of Secretaries’ extra-textual arguments—whether based on economics, “unintended” results, or legislative history—is persuasive. The Court will enter judgment in favor of the House of Representatives and enjoin the use of unappropriated monies to fund reimbursements due to insurers under Section 1402. The Court will stay its injunction, however, pending appeal by either or both parties. …

The only result of the ACA, however, is that the Section 1402 reimbursements must be funded annually. Far from absurd, that is a perfectly valid means of appropriation. The results predicted by the Secretaries flow not from the ACA, but from Congress’ subsequent refusal to appropriate money. Such an appropriation cannot be inferred, no matter how programmatically aligned the Secretaries may view Sections 1401 and 1402. See 31 U.S.C. § 1301(d) (“A law may be construed to make an appropriation out of the Treasury . . . only if the law specifically states that an appropriation is made”). “This principle is even more important in the case of a permanent appropriation.” Remission to Guam & Virgin Islands of Estimates of Moneys to be Collected, B-114808, 1979 WL 12213, at *3 (Comp. Gen. Aug. 7, 1979).

Paying out Section 1402 reimbursements without an appropriation thus violates the Constitution. Congress authorized reduced cost sharing but did not appropriate monies for it, in the FY 2014 budget or since. Congress is the only source for such an appropriation, and no public money can be spent without one. See U.S. Constitution, Art. I, § 9, cl. 7 (“No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law . . . .”). The Secretaries’ textual and contextual arguments fail.

HHS has been enjoined from paying subsidies to insurers through 1402, although Collyer stayed the order while the Obama administration prepares an inevitable appeal. Without these subsidies, insurers will high-tail it out of the exchanges, a process that’s already under way. And for good reason, as I note in my column today at The Fiscal Times:

As the fourth year of Obamacare approaches, Politico’s Paul Demko reports that consumers can expect more of the same price hikes and narrowed choices as they have seen the first three years. The Obama administration insists that prices only rose eight percent for 2016 over the previous year – even though that itself is still more than three times the rate of inflation, and ignores states like Minnesota where the average premium increase was over 30 percent.

“There are reasons to think the next round may be different,” Demko warns. He quotes a Deloitte executive who agrees. “A number of carriers need double-digit increases” for 2017. Those price increases will hit the Obamacare exchanges on November 1st, one week before voters elect a new President and Congress.

Kaiser Health News reports that 2017, far from being the year that stabilizes the Obamacare exchanges, will be another “adjustment year” for the risk pools. Even the director of Covered California expects to see higher rate increases in the fourth year of Obamacare than previously seen, although Peter Lee shrugs off the risk for his own exchange. “There are a number of reasons 2017 will have higher rate increases than the last few years,” Lee tells KHN. “But we believe in California we won’t see the significant headwinds many other states are experiencing.” However, Lee would not answer when KHN asked if UnitedHealth Group had applied to participate in Covered California for 2017.

This brings us back to the ability to keep one’s plan. UnitedHealth has made clear its intentions to exit most of the state Obamacare markets next year, and California may well be one of them. A more troubling exit looms on the horizon – the exit of all insurers from the lowest-cost bronze plans.

Continued below due to length

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

If this stands, House Republicans may have finally put a stake through the heart of ObamaCare. If so, they’d better start delivering on their promises for a coherent replacement.

Update: The White House remains defiant:

The White House said on Thursday the U.S. Department of Justice was still deciding whether to appeal a court ruling challenging President Barack Obama’s healthcare law, but a spokesman predicted Republicans ultimately would lose the fight.

“This suit represents the first time in our nation’s history that Congress has been permitted to sue the executive branch over a disagreement about how to interpret a statute,” White House spokesman Josh Earnest told a briefing.

Maybe it’s the first time that the executive branch spent discretionary funds that Congress hadn’t appropriated.

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

Share on Facebook 122 122 SHARESOregon has long set itself on the leading edge of ObamaCare failure. Their state exchange portal suffered catastrophic failure on launch, and after several months finally gave up entirely. That epic example of government incompetence cost US taxpayers more than $300 million.

At least their co-op lasted longer than those in most other states. In a classic Friday night news dump, the state intervened to shut down its last remaining ObamaCare co-op after the government realized that it had badly misrepresented how much federal funding it would receive:

The Oregon Department of Consumer and Business Services, which regulates insurance, is taking action to shutter the carrier after the Centers for Medicare and Medicaid Services announced last week the CO-OP owes about $900,000 to the federal risk adjustment program, which pays health insurers that take on a disproportionate number of sick enrollees under the Affordable Care Act. The CO-OP expected to receive about $5 million from the program.

“The issue was the company badly misestimated the amount it would receive from the program,” DCBS Director Patrick Allen said.

That’s curious in and of itself. Supposedly, the co-ops exist to specifically address that contingent of sick enrollees. That report suggests that the co-op had a healthier than average risk pool in the ObamaCare system; otherwise, it would be a net recipient in the risk-adjustment program, not a net contributor. Even with that, the government-backed co-op still couldn’t make the ObamaCare model work — not even with the 32% increase in premiums it had requested and received for 2017. The Bend Bulletin reports that the co-op lost $18.4 million in 2015, and it looks like things got worse this year.

Like most of the other co-op failures, the failure of Health CO-OP doesn’t just impact next year’s enrollments. It throws people out of their insurance at the end of this month, requiring them to enroll in a new plan by August 1 in order to maintain coverage. That affects more than 20,000 people in Oregon, and if they live in the central part of the state, they now only have two options — Health Net and Pacific Source, both of whom raised their rates for 2017 by 9% and 15% respectively. And Health Net doesn’t actually offer plans through the ObamaCare exchange anyway.

Allen says that’s all the choice Central Oregon needs anyway:

Allen said he realizes the CO-OP’s departure leaves many areas of the state with a serious lack of carrier choices. He said his agency will work to identify steps it can take to encourage carriers to re-enter certain counties. One possibility could be the extension of a state program that provided financial support to insurers but ended this year, he said.

In any case, Allen said two carriers is “certainly” enough going into 2017.

“There are something like 500 counties across the country that have just one carrier,” he said. “However, it’s something that we’re concerned about. Vigorous competition has been a hallmark of the Oregon marketplace.”

A vigorous competition of … one?

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

That epic example of government incompetence cost US taxpayers more than $300 million.

Meh. We spend that much every week subsidizing Saudi terrorists. Each day subsidizing foreign powers. I'm good with spending taxpayers money attempting to make things better for Americans. Even if the attempt fails. IMO we should cut the DoD budget to $200B/year, eliminate medicare, medicaid, the VA, spend $600B/year on a suite of nationwide government run clinics to treat the treatable conditions (injuries, treatable infections, medications for maintenance conditions) and let anyone who wants it purchase catastrophic health care insurance or end of life care insurance.

There. I just made health care in the USA 100% more effective, 600% more efficient, and saved the taxpayers almost half a trillion dollars per year. Also, just reduced the danger of the USA being dragged into someone else's war on behalf of a few wealthy Americans and a few politicians with compensation issues.

1) Just like retroactive flood insurance, sign up whenever anything bad happens is a terrible idea

2) The alleged cost savings were...wait for it...bullshit

In California the Covered California plans are mostly a disaster. The high deductible "copper tier" plans are bullshit. Patients are unwilling to get needed care because of the deductible amounts and many will not even fill needed prescriptions because the co-pay is $25 on a $300 medicine.

The medicaid hybrid "share of cost" plans have unbelievable crappy drug formularies to control cost. The good news is what is covered is free...the bad news is nothing invented after 1940 is covered. It's impossible to treat bad asthmatics. You have to try to keep them going with free drug samples. God forbid they have a psychiatric problem because the county mental health clinic has an 8 month waiting list unless you have at least 4 personalities. My office has turned into a trauma clinic because there aren't any goddamn orthopedists signed up for the crappy plans (because of the preposterous administrative burdens and crappy reimbursement). If you are going to tell people they have health insurance then it has to be funded adequately to meet the needs. You can't have nimrods in Washington and Sacramento expanding the number of those "covered" and not being honest about the needed funding. It's not even remotely close.

Of course, that doesn't stop the La Raza legislature from expanding it to illegals which was another explicit promise of Obamacare.

_________________I haven't figured out how to the block thingy works but if anyone alters my posts I will become really, really angry and throw monkey poop out of my cage.

Illinois Insurers to Increase Premiums as High as 45%Blue Cross Blue Shield of Illinois proposed increases from 23 to 45 percent

BY: Ali Meyer August 2, 2016 11:20 am

Insurers in Illinois are set to increase premiums by as much as 45 percent for those buying coverage through the Obamacare marketplace, the Chicago Tribune reported.

The most popular insurer in Illinois on the Affordable Care Act exchange, Blue Cross Blue Shield, has proposed increases from 23 to 43 percent for premiums for individual health-care plans saying the hike is due to changes in the cost of medical services.

“No final decisions have been made regarding our 2017 offerings,” the insurer said. “While some carriers have chosen to exit the market, we are working toward continuing to provide health insurance options for consumers in Illinois. However, that must be done in a sustainable way.”

Another insurer, Coventry Health Care of Illinois, has proposed a rate increase of 21 percent.

“The increases aren’t a surprise as many insurers have been losing money in the marketplace,” according to Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation.

“I don’t think the Insurance Department wants to push the carriers off a cliff and tell them they can’t raise their rates and then they’re upside down actuarially,” Hempstead told the Chicago Tribune. “You can’t sustain a situation where most carriers lose money.”

Hmmmm.....So didn't the creators of this system realize that it was unsustainable?

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

Conservatives have long suspected that the long-term goal of ObamaCare is to force the adoption of a single-payer system. Progressives have occasionally advocated for that transition, and of course Bernie Sanders campaigned for the Democratic presidential nomination on the basis of “Medicare for all.” We may soon find out whether it’s true. The crisis may hit as soon as next February, The Hill’s Sarah Ferris notes, regardless of which candidate wins:

The next president could be dealing with an ObamaCare insurer meltdown in his or her very first month.

The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces.

The fourth ObamaCare signup period begins about one week before Election Day, and it will end about one week before inauguration on Jan. 20. After mounting complaints from big insurers about losing money this year, the results could serve as a kind of judgment day for ObamaCare, experts say. …

Levitt and other experts warn that if the numbers don’t improve this year, more insurers could bolt. That would deal a major blow to marketplace competition while also driving up rates and keeping even more people out of the exchanges.

Already, many insurers this year are proposing substantial rate hikes with the hopes of making up for higher recent medical costs. The average premium increase next year is about 9 percent, according to an analysis of 17 cities by the Kaiser Family Foundation. But some hikes are far higher: Blue Cross Blue Shield has proposed increases of 40 percent in Alabama and 60 percent in Texas.

If the Trojan-horse theory holds, then the next argument we’ll get from the inevitable ObamaCare collapse is that only a total takeover of the US health-care system will save it. However, a new study from Colorado shows that a single-payer system would produce a similar collapse into a sea of red ink, shrinking provider bases, and skyrocketing costs and taxes. Advocates for state-wide socialized medicine managed to qualify a referendum for the November ballot, but an independent study of the proposal says that it will start off in the red — and only sink further and further every year. By the end of its first decade, it will have a $7.8 billion deficit, even with federal subsidies (via Matt Vespa):

If the Trojan-horse theory holds, then the next argument we’ll get from the inevitable ObamaCare collapse is that only a total takeover of the US health-care system will save it. However, a new study from Colorado shows that a single-payer system would produce a similar collapse into a sea of red ink, shrinking provider bases, and skyrocketing costs and taxes. Advocates for state-wide socialized medicine managed to qualify a referendum for the November ballot, but an independent study of the proposal says that it will start off in the red — and only sink further and further every year. By the end of its first decade, it will have a $7.8 billion deficit, even with federal subsidies (via Matt Vespa):

The 2016 ballot initiative to give every Coloradan healthcare won’t be able to cover its costs, according to a study released Monday by the Colorado Health Institute.

That’s despite the fact that the proposed amendment 69, known as ColoradoCare, would more than triple the amount of taxes collected by the state.

“Simply put, the revenue would not be sufficient,” the report stated. “CHI’s model projects that the revenue from taxes and federal funds would fall just short of paying ColoradoCare’s bills in the first year – with widening deficits in each subsequent year.”

The study suggests ColoradoCare would have to cut benefits, raise taxes or reduce payments to doctors and hospitals to achieve long-term financial solvency. The ballot language would empower the proposed 21-member board to make such decisions.

In my column for The Fiscal Times, I argue that this is the inevitable result when government seizes control of private-sector economies. The solution should not be the hair of the dog that bit us:

In a monopolistic government-run system, what options would Colorado residents have to fix these problems? CHI offers three ways to keep ColoradoCare from collapsing. The government-run system “could ask its members to approve tax increases,” (emphasis mine), which would erode buying power across the board and have a negative effect on the economy. Failing that, the government could choose to provide fewer benefits or stiff providers with lower payments.

These are precisely the options left when the government takes over a private-sector function. It operates from a scarcity model, choosing to ration and tax where a healthy market would provide opportunities for price signaling, competition, and increased production. None of the potential solutions to the fiscal crisis that would result from ColoradoCare add to the choices or options consumers would have in the market; it either restricts their buying power, their choices, or their providers. After all, how many doctors will choose to work and live in Colorado in a system where the government restricts what they can make from their work, and keeps reducing their pay?

Those who see private markets as zero-sum games may never be convinced of the folly of single-payer systems. The rest of us, however, must demand an end to this failing Obamacare system and an end to the fantasy of socialized medicine at the state or federal level. The only way to control health-care costs is to establish lightly regulated markets with price signaling to consumers, encouragement for providers to enter the market and a rational reconstruction of the concept of insurance to its proper place as an indemnification against unforeseen circumstances rather than as a maintenance program.

Until we do, we will continue to generate vast oceans of red ink and destroy an American health industry known for its innovation and expertise.

_________________The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.- misattributed to Alexis De Tocqueville

No representations made as to the accuracy of info in posted news articles or links

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